Docket: IRS-2009-0008 

Request for Information for Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 

2008 

Comment On: IRS-2009-0008-0001 

Request for Information Regarding the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction 

Equity Act of 2008 

Document: IRS-2009-0008-0092 

Comment on FR Doc # E9-09629 

Submitter Information 

Name: Dr. Judy M. Schwartz, Ph.D. 

Address: 

Cincinnati, OH, 

Submitter's Representative: Honorable John A. Boehner 

Organization: The Neurofeedback Clinic of Cincinnati 

General Comment 

I am a psychologist who provides neurofeedback treatment to individuals with 

Attention Deficit/Hyperactivity Disorder, Traumatic Brain Injury, Stroke, Autism 

Spectrum Disorder, and other neurologically-based disorders as well as mood 

disorders. Neurofeedback is an empirically validated and widely recognized 

effective non-medication treatment for ADHD as well as other conditions. There 

are over 50 studies evaluating the effectiveness of neurofeedback in the treatment 

of ADHD, substance use disorders and autism. A recent review of this literature 

concluded "Neurofeedback meets the American Academy of Child and 

Adolescent Psychiatry criteria for Clinical Guidelines for treatment of ADHD." This 

means that neurofeedback meets the same criteria as medication for treating 

AD/HD, ( 60% of prescriptions are in fact prescribed "off label") and that 

neurofeedback "should always be considered as an intervention for this disorder 

by the clinician." 

Neurofeedback services have been denied by Medicaid, Aetna, United Behavioral 

Health, Blue Cross, Cigna, and Amerigroup. 

These denials limit an effective and validated treatment for mental health 

problems. The reasons given by insurance companies for these denials fell into 

two categories: 1). our company does not cover biofeedback for mental health 

problems or 2). there is not yet sufficient evidence for the efficacy of 

PUBLIC SUBMISSION 

As of: May 29, 2009 

Tracking No. 809bc074 

Comments Due: May 28, 2009
neurofeedback. As such, these companies are using evidence-based criteria that 

are far more restrictive for mental health services than the criteria which are used 

for medical/surgical services. There are many routine medical/surgical procedures 

which have far fewer controlled studies about their efficacy than does 

neurofeedback. These medical/surgical procedures are generally not limited 

because of concerns about how many controlled studies have been performed 

about them. 

I believe that the parity regulations, based on legal reviews of the parity statute, 

should require that employers and insurance plans pay for the same range and 

scope of services for behavioral treatments as they do for medical/surgical 

benefits and that a plan cannot be more restrictive in their managed care criteria 

and reviews for mental health and substance abuse disorders when compred to 

medical/surgery. Today insurance plans are more restrictive in how they review 

evidenced-based mental health and substance abuse treatments compared to 

medical/surgical treatments. This violates both the intent and letter of the parity 

statute and I hope that the regulations will clarity that this cannot continue. 

Sincerely, 

Dr. Judy M. Schwartz, Ph.D.